Helping people with dementia make their own decisions

Don't make decisions for people with
dementia that they can make themselves

People with dementia may have difficulty making some
decisions but will be able to make other decisions
themselves. For example, a person might not be able to
make decisions about their medical treatment, but could
make decisions about what they eat or which television
programmes to watch.

Different people with dementia will be able to make different
decisions. As the dementia progresses the decisions an
individual will be able to make will change.

Sometimes you have got to make a decision to do something or other and you are not quite sure whether you should, so you need a very good friend to help you to go through it.

Person with dementia quoted in ‘My name is not dementia’ (Alzheimer’s Society, 2010)

For some people with dementia, there will be times when
they could make a particular decision and times when it
would be harder for them to do this. For example, many
people with dementia find it harder to concentrate later in the
day. If a decision can wait until a person can make it
themselves, this is what must happen.

Supporting people to make their own
decisions

Where possible, people must be supported to make their
own decisions. The kinds of support people with dementia
may need include:

making sure their hearing aid is working, or they have
their glasses on

explaining things in a way that is easy to understand

using pictures, for example when choosing what meal
to have

having someone who can speak the person's own
language to explain the decision to them

choosing the best time of the day to talk about the
decision.

Some decisions are very difficult and people may need time
to make them. People might also change their mind several
times. This doesn't mean they can't make the decision
themselves.

What if I disagree with the person's decision?

Just because you think a person is not making a sensible
decision doesn't mean that they can't make that decision for
themselves. For example, a person might choose not to eat
any vegetables or fruit. Another person might choose to
spend more money on alcohol than you would.

The law says that people can make unwise decisions. For
example, we all know it is unwise to smoke, but the law
allows adults to do so.

If you are worried about a decision someone has made, you
might want to check that they understand what they are
doing.

The Social Care TV video, 'Raymond's Money', looks at the
dilemma faced by a home care worker, Wendy, who is asked
by Raymond, a man newly diagnosed with dementia, to
place a large sum of money on the Lottery. Wendy doesn't
think this is a good decision, but Raymond's wishes are
clear. Notes accompanying the film discuss the principles of
the Mental Capacity Act and how they can be applied to this
story.

Downloads

All SCIE resources are free to download, however to access the following downloads you will need a free MySCIE account:

Useful links Open

Dementia:
Making decisions
This 2012 guide from Alzheimer Scotland offers practical advice and information
on decision-making for people appointed to make decisions on behalf of someone with
dementia either as an attorney or guardian (in Scotland) or deputy (in England and
Wales).